warning them of the downturn to come and added that research grants, too, were becoming less likely to receive funding. He noted that each grant’s costs, like the costs of medical technology and hospital and school construction, all had “doubled in about two years.” The downturn in federal funding, it should be noted, coincided exactly with the years of UMMS’s efforts to raise construction funds and, literally, get off the ground.28
Therefore, some new medical schools faced financial barriers that precluded following the academic medical center model. By the late 1960s, as a faculty member from one of these schools wrote, “Issues of minority admissions, affirmative action, educational and financial supports for disadvantaged students, and medical care for the poor became preeminent in the consciousness of all of us.” According to data compiled by the AAMC, schools that opened between 1970 and 1980 allotted, on average, 65% of their first-year slots, to women applicants, significantly above the norm. Funding exigencies, however, discouraged any ambitions to become elite research centers –at least for awhile. For example, “many new schools found it necessary to use community hospitals…whether by choice or because of the essential unavailability of federal funds for university hospital construction after about 1970…” The new, community-based schools relied more on community physicians for teaching than established schools, and often had less authority over hospital policies than at university hospitals.29 In the words of Richard Egan, M.D., Secretary to the Council on Medical Education of the AMA, echoing Coggeshall, “There is understandably a concern about the creation of new schools that may, at least superficially, bear some resemblance to the prereformation [i.e. pre-Flexnerian] schools.”30
True, some of the new cohort, such as the University of California at San Diego Medical School, or Mt. Sinai, for example, became almost immediate successes as research enterprises - in large part due to their affiliation either with a research university or a venerable and wellendowed hospital. Many others, however, either took much longer to reach that status or made no plans to follow that path. The new schools of the 1960s and 1970s more often made their reputations not only via their more diverse student bodies, or by more readily integrating family medicine or general internal medicine into their undergraduate and graduate programs, but also
by affiliating with community hospitals and clinicians.31 Finally, new schools were associated with curriculum innovation to introduce medical students to actual patients in their first two years, and enhancing clinical science education with behavioral and social science. They thus early acquired the reputation of espousing, “a somewhat different set of values than did their established
institutional peers.”32 As noted by President John Z. Bowers of the Macy Foundation, which had begun funding curriculum innovation grants as early as 1954, “Primary care and
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